Sunday, July 6, 2008

Doctor, it hurts when I do this

March 1, 2004 was a sunny winter day in Providence. I was hard at work at home, crouched over my laptop. Earlier, my advisor and I had made a decision. I would abandon my current project and develop an unrelated idea, one that I had just sketched out on his office white board. The idea was good. It would become my master's thesis and an award-winning paper in a respected academic journal. It was also small and self-contained, which made the switch possible at all, this late in the program, a mere three months before the deadline for submission. It was a daring, almost reckless switch. It set me up in a race against the train to the crossing. I agreed with the new plan because, frankly, I love trainrunning.

The week prior to the sunny winter day in question, my wrists had been bothering me more than usual, though I took only passing notice of it. Mostly, I spent my time two miles deep into focus, coding, oblivious to the real world. But that afternoon, the pain finally grew beyond my ability to ignore it. I stood up, tried to make step but I was overwhelmed by the pain -- it sapped my balance and I kneeled on the floor, holding my injured arm with my merely-bad one.

That was the last time I programmed with my own hands. In the intervening four years, I have designed three large programs and directed the teams set up to construct them, but any lines of code I wrote I wrote as the copilot of a coding pair. My hands refuse any contact with a keyboard with the virulence of an immune system response. If I try to type, the pain creeps up and stops me before I have accomplished much. So long as I keep away from keyboards, I am mostly fine, and my condition has improved with time. I enjoy the occasional day without symptoms, and I rarely need to fetch my electrotherapy machine anymore. In comparison, there was a time when I spent entire days under ice, begging for forgiveness. I'm glad that's over.

I saw a doctor within a week of my injury. He gave me injections of cortisone and sent me home without two crucial pieces of advice (1. Don't type through the pain. 2. So long as the medicine is active, your tendons are as weak as al dente pasta.) The doctor I saw before him, in 2003, gave me a brace and sent me back to work. In 2002, I tried to consult with the company's ergonomist, but the waiting list turned out to be longer than my internship. In fact, the onset of my tendinitis can be traced back as early as January 2001, when I complained to my family doctor about occasional wrist pain. He reassured me that I was not showing the symptoms of carpal tunnel syndrome, and wished me luck for my new life in the United States.

My story is shockingly common. In the period between 2002 and 2006, each year one of my colleagues would develop a serious disability due to keyboard usage. Behind them, there was a long tail of programmers with various amount of wrist pain. Recently, I had the chance to stand on stage and ask a room of programmers for a show of hands, who had wrist pain? Nearly everyone did. This is not okay. It makes computer science by far the most dangerous department to work for. Physicists in rapid explosion labs do not injure themselves nearly as often as we do. Biologists in level 5 labs working with revived strains of dangerous viruses do not injure themselves as often as we do. They are careful. Why can't we?

Something about RSI makes it fall through the cracks of the Western system of medicine. The efforts necessary to prevent RSI do not seem to fit in the 15 minute window that compose an appointment with a generalist doctor. To compensate, sometime in 2005 my colleagues Jenine, Liz and myself coalesced into an ad hoc RSI prevention team. Together, we taught the physiology of the wrist and the rules of ergonomy as a compulsory lecture to the incoming students. Throughout the year, we continued the teaching, one-on-one. We invited ergonomy experts, made ice packs available, and put together a lending library of ergonomic keyboards. It made a difference, and I have hope that the habits the community learned during that time will persist, since we also taught the students to teach each other.

I have gathered these lessons into a single article. Then I translated it so I had a French and English version.

If your wrists hurt and you want to prevent them from creeping further after you, read ahead. If your wrists are fine, read as well, so you can help the programmer in your life whose wrists are probably hurting in silence.

Playing for the crowd

Yesterday I met Vincent, the gym teacher of a local high school. The school is built as two floors of mezzanines surrounding a central badminton court. We entered the school grounds during recess. Here, like in any schools, whenever a stranger intrudes in the daily routine, it is an event. There I was, a stranger, strange and a foreigner no less. Within seconds, I had two floors worth of high schoolers around me, their eyes following my steps. I have never felt such power over a crowd. At that moment and I could have yelled «cricket sucks!» and generated a riot. I choose instead to wave enthusiastically, and the whole crowd waved back ecstatically. Trust high schoolers amplify emotions; you can't beat that kind of energy.

Vincent and I set up a badminton game on the outside court, and I proceeded to attempt to beat the entire school. This was my first badminton game since my injury forced me to stop playing. My goodness, this sport is as much fun as ever. But more importantly, this match means that I am healing, bit by bit, year by year. And perhaps one day day I will be able to play at coding again.